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FLAGELLATES – GIARDIA
LAMBLIA AND
TRICHOMONAS VAGINALIS
-DR.M.JANE ESTHER
MD (Microbiology)
FLAGELLATES
 Intestinal flagellates
 Haemoflagellates
INTESTINAL FLAGELLATES:
 Giardia lamblia
 Genital flagellate-Trichomonas vaginalis
GIARDIA LAMBLIA
 First observed by Leeuwenhoek
 Prof Giard and Prof Lambl – detailed description
 Most common intestinal protozoan pathogen
 Distribution : Worldwide
 Habitat: duodenum & upper part of jejunum
 2 forms : Trophozoite & cyst forms
 IgA deficient individuals
TROPHOZOITE PHASE:
 Rounded anteriorly and pointed posteriorly
 Pyriform, heart or tennis racket shaped
 15µm long and 7µm wide
 B/L symmetrical
 Axostyle
 2 nuclei
 4 pairs of flagella
FALLING LEAF MOTILITY
 2 sausage shaped para median bodies posterior
to sucking disc
 Motility: Falling leaf
 Division: Longitudinal binary fission
CYST
 Oval; 12µm long and 7µm broad
 4 nuclei
 Acid environment  Encyst
LIFE CYCLE
 Trophozoite (multiply in duodenum)
 Unfavourable conditions –
encystment(LI)
 Ingestion of cysts - infection
 Hatch out in duodenum 
Trophozoites released
 Colonise duedenum & biliary tract
PATHOGENICITY
 Parasite attaches to the epithelial cell surface
 malabsorption & steatorrhoea
 Toxic (allergic) effect
 Traumatic & irritative effect
CLINICAL FEATURES
 Giardiasis
 Intestinal : Enteritis & enterocolitis
 General : fever, anaemia, allergic
manifestations
 Chronic cholecystopathy
LAB DIAGNOSIS
 Stool examination – giardia cyst & trophozoite
 Enterotest
 ELISA
 Immunochromatographic strip tests
ENTEROTEST
TREATMENT
 Metronidazole (250 mg tds for 5 days)
 Trimidazole (2 g once)
 Furazolidone (100 mg 4 times a day for 7-10
days)
TRICHOMONAS VAGINALIS
 First observed by Donne in vaginal secretion
 Occurs only as the trophozoite
 No cystic form
 Habitat
 Females : vagina, urethra, bartholin’s gland
 Males : urethra, prostate anterior preputial
sac
MORPHOLOGY
 Ovoid or pear shaped
 10 to 30µm long and 5 to 10µm broad
 Undulating membrane
 Costa
 4 ant flagella & 5th running along undulating
membrane
 Axostyle
Continued….
 Jerky motility
 Binary fission
 Infetive form : trophozoite
 Culture : CPLM madium
(cysteine,peptone,liver,maltose)
LIFE CYCLE
PATHOGENESIS
 IP:4 days to 4 weeks
 Squamous epithelium & not columnar
 Disruption of glycogen levels & bacterial flora
 Rise in pH level(exceeds 4.9)
CLINICAL FEATURES
Trichomoniasis
WOMEN:
 Vulvo-vaginitis
 Urethritis
 Purulent abnormal vaginal discharge(yellow
greenish)
 Vulval & vaginal epithelium – Fiery red
 Ectocervix : punctate hemorrhages (strawberry
mucosa) – colpitis macularis
MALES:
 Urethritis
 Epididymitis
 Prostatitis
 Prepuce ulceration
LAB DIAGNOSIS
 Microscopy :urine wet mount  Trophozoite
 Giemsa stain
 Culture – CPLM
 Indirect haemagglutination
 PCR
TREATMENT
 Metronidazole 250 mg oral tds for 5-7 days
SUMMARY
 Giardia lamblia : Trophozoite & cyst – falling leaf
motility – giardiasis
 Trichomonas vaginalis : only trophozoite, no cyst
form, jerky moltility, trichomoniasis
Giardia and trichomonas

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Giardia and trichomonas

  • 1. FLAGELLATES – GIARDIA LAMBLIA AND TRICHOMONAS VAGINALIS -DR.M.JANE ESTHER MD (Microbiology)
  • 2. FLAGELLATES  Intestinal flagellates  Haemoflagellates INTESTINAL FLAGELLATES:  Giardia lamblia  Genital flagellate-Trichomonas vaginalis
  • 3. GIARDIA LAMBLIA  First observed by Leeuwenhoek  Prof Giard and Prof Lambl – detailed description  Most common intestinal protozoan pathogen  Distribution : Worldwide  Habitat: duodenum & upper part of jejunum  2 forms : Trophozoite & cyst forms  IgA deficient individuals
  • 4. TROPHOZOITE PHASE:  Rounded anteriorly and pointed posteriorly  Pyriform, heart or tennis racket shaped  15µm long and 7µm wide  B/L symmetrical  Axostyle  2 nuclei  4 pairs of flagella
  • 5. FALLING LEAF MOTILITY  2 sausage shaped para median bodies posterior to sucking disc  Motility: Falling leaf  Division: Longitudinal binary fission
  • 6. CYST  Oval; 12µm long and 7µm broad  4 nuclei  Acid environment  Encyst
  • 7. LIFE CYCLE  Trophozoite (multiply in duodenum)  Unfavourable conditions – encystment(LI)  Ingestion of cysts - infection  Hatch out in duodenum  Trophozoites released  Colonise duedenum & biliary tract
  • 8. PATHOGENICITY  Parasite attaches to the epithelial cell surface  malabsorption & steatorrhoea  Toxic (allergic) effect  Traumatic & irritative effect
  • 9. CLINICAL FEATURES  Giardiasis  Intestinal : Enteritis & enterocolitis  General : fever, anaemia, allergic manifestations  Chronic cholecystopathy
  • 10. LAB DIAGNOSIS  Stool examination – giardia cyst & trophozoite  Enterotest  ELISA  Immunochromatographic strip tests
  • 12. TREATMENT  Metronidazole (250 mg tds for 5 days)  Trimidazole (2 g once)  Furazolidone (100 mg 4 times a day for 7-10 days)
  • 13. TRICHOMONAS VAGINALIS  First observed by Donne in vaginal secretion  Occurs only as the trophozoite  No cystic form  Habitat  Females : vagina, urethra, bartholin’s gland  Males : urethra, prostate anterior preputial sac
  • 14. MORPHOLOGY  Ovoid or pear shaped  10 to 30µm long and 5 to 10µm broad  Undulating membrane  Costa  4 ant flagella & 5th running along undulating membrane  Axostyle
  • 15. Continued….  Jerky motility  Binary fission  Infetive form : trophozoite  Culture : CPLM madium (cysteine,peptone,liver,maltose)
  • 17. PATHOGENESIS  IP:4 days to 4 weeks  Squamous epithelium & not columnar  Disruption of glycogen levels & bacterial flora  Rise in pH level(exceeds 4.9)
  • 18. CLINICAL FEATURES Trichomoniasis WOMEN:  Vulvo-vaginitis  Urethritis  Purulent abnormal vaginal discharge(yellow greenish)  Vulval & vaginal epithelium – Fiery red  Ectocervix : punctate hemorrhages (strawberry mucosa) – colpitis macularis
  • 19. MALES:  Urethritis  Epididymitis  Prostatitis  Prepuce ulceration
  • 20. LAB DIAGNOSIS  Microscopy :urine wet mount  Trophozoite  Giemsa stain  Culture – CPLM  Indirect haemagglutination  PCR TREATMENT  Metronidazole 250 mg oral tds for 5-7 days
  • 21. SUMMARY  Giardia lamblia : Trophozoite & cyst – falling leaf motility – giardiasis  Trichomonas vaginalis : only trophozoite, no cyst form, jerky moltility, trichomoniasis